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Mortality rate drops more than 40% among patients hospitalized with cirrhosis

The mortality rate of patients hospitalized for cirrhosis has decreased more than 40% between 2002 and 2010, despite an increase in hospital admissions, according to newly published data.

“While the number of cirrhosis hospitalizations increased during the sample period, the rate of hospital deaths fell by 41%,” Monica L. Schmidt, MPH, research associate at the UNC Liver Center and doctoral candidate at the Gillings School of Global Public Health, said in a press release. “In addition, the decline in mortality for cirrhosis patients dropped significantly compared to non-cirrhotic patients. Increased awareness of disease management and earlier diagnosis for cirrhosis-related complications may have led to better survival rates.”

Monica L. Schmidt

Schmidt and colleagues analyzed data from the Healthcare Cost and Utilization Project, National Inpatient Sample, of 781,515 patients hospitalized with cirrhosis between 2002 and 2010. This data was compared to equal number of patients hospitalized without cirrhosis and patients with congestive heart failure (CHF).

Overall, inpatient mortality rates for patients with cirrhosis decreased from 9.1% in 2002 to 5.4% in 2010. There was also a decrease in mortality rates in patients without cirrhosis and patients with CHF, but to a lesser degree, according to the research. The CHF patients had a similar percentage decrease in mortality as the patients with cirrhosis compared with the patients without cirrhosis (44% and 41% vs. 19%), respectively.

Hospital length of hospital stay decreased from a mean of 6.95 days in 2002 to 5.88 days in 2010 (P < .001).

Hepatorenal syndrome, hepatocellular carcinoma, variceal bleeding and spontaneous bacterial peritonitis were associated with a higher mortality rate. However, the independent mortality risks for each decreased steadily over time, according to the research. Sepsis was linked with a strong increase in mortality and increased over time.

“The improving inpatient survival despite aging and more medically complex cirrhotic patients is remarkably consistent across several cirrhosis complications and suggests improving cirrhosis care that may extend beyond general improvements in inpatient care,” the researchers wrote. “As cirrhosis-related admissions continue to increase and hospitals increasingly are held accountable for outcomes, our data may help in setting appropriate quality care indicators, including guideline use, adjusted mortality risk and use of palliative care.” – by Melinda Stevens

Disclosure: The researchers report no relevant financial disclosures.